12359 SW KING GEORGE DRIVE 12359 SW King George Ur. KC
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INSPECTION NOTICE
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City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _ _.,Z�c�-r_YZ L�C-c
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Date Requested Lt_� �.— /— �S 1 Time 4.M.._, c P.M.
Address �GZaJ�t GZ_ Gj _� %C Permit #� a GJ�LI
Owner I Lot #
Builder!,
The following Building Code deficiencies are required to .p corrected-.
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Presented to Approved
Inspector ��� __----- — I I Disapproved
bate
CALL FOR REINSPECTION
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HEATINti&COMING. INC.
2915 N E.UNION AVE.
POR'i LAND•OREOON•977.12
Aff 77-1 EXPERT INSTALLATIONS BIFICE 1961
FILTEX CONTROI"ACUUM 6MEMS
PAUL E.DAUGHERTY
2M-2173
A, M
CITY OF TIF.A ECHANTCAL. EPMVI
RD AgI411111M 1:4--_11MIJ NO . : VIME""(362501
CITY
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S W Hall Blvd..P.O.Box 23397 Tigard.Oregon 97223,(503)A94175 1*.)(1*IF..: ISSUEU : 32/30/08
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1:I.IL I i I I ; A UL.P/tIc)mp 30'....50HP PE.;P141P UNITS
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NO 2PP TO TAI *P5 .
This permit is ssued subInct tc the regulation.-ontained In Title 14 WE(. EA3--T N(5 . A-1
of the TMG. Siale of Oregon Specialty Codes,zoning regulations .........
and all other applicphle, codes and ordinanL)s, and It Is hereby REMU-144-N) 1-INISPECTIONS
agreed that the v ork will be done In accordance with the plans and GAS L INE
specifications ai d in compliance with all applicable codes And 1::I(J
ordinances. The issuance of this permit does not waive restrictive S V & "I,--::Am
covenants Contractor and subcontractors shAl' have rurrent city POLIGH :CN
business tax pe,,nits This permit will expire and become null and V 'TNAL
void if work is r.ot started within 180 days.or if work Is suspended or
abandoned or a period of 180 days any time after work has
comment'd. It shall be the responsibility of the permittee to assure
all requin d inspectionc are requested and Approved.
Permittee Signalul,
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Issued By
t'AtI.. FOP TW-4."I"J"I TON
SEPAL A' PERMITS REQUIRED FOP WORK OTHER THAN DESCRIBED ABOVE
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CITY OF KfNG CITY
15300 S .W. 116th AVENUE
KING CITY , OREGON 977.24
(503) 639-4082
APPLICATION FOR
COMPLIANCE REVIL-W BOARD PERMIT
1 . NAME OF APPLICANT : All, 1 13. Urid,
ADDRESS: 11 S 4r1U('" 6r"y/'��C r12
TELEPHONE NO. 0115—
ADDRESS OF PROPOSED 'tri?ROVEMENT 54141=
!. 2 . TYPE OF CHANGE, IMPROVEMENT OR CONSTRUCTION FOR WHICH PERMIT
IS REQUESTED. (DESCRIBE @RIEFLr/ATTACH TWO COPIES OF PLANS
OR DRAWINGS OF WHAM IS PROPOSED) : d'vSAJt6o. 4 AifiL) /,!!Rq-04.s_�
tiY wt j!!f' C'ch;�:7�,l,rJq' •s 5 ,1/ /,L50 /NS I j[Cgr7?,1
C1' 6(1L7�'1,JrC r'A' ('(IL'r0'F /,'r+/J JN JNS-419lia)
3. NAME AND ADDRESSES OF CONTRACTOR: 4111) lito'17'Uj
-
` 4. NAMES AND AD4)RESSES OF NEIGHBORS WHO MAY BE AFFE,TED BY THIS
CHANGE , IMPROVEMENT OR CONSTRUCTION. ( IT IS THE APPLICAN- 15
RESPONSIBILITY TO NOTIFY EACH NEIGHBOR) :
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SIGNATURE OF APPLICANT ,�ZQ (`
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DATE OF APPLICATIOP. � _ � �� Igg>V
�IOFFICE USE ONLY : ---�--� _�
I APPLICATION RECEIVED BY DATE J
APPLICABLE FEE RECEIVED $10.00 OTHER TOTAL PAID_z
APPLICATION REVIEW SCHEDULED: DATE
COMPLIANCE REVIEW BOARD - DECISION:
APPROVED !lk DATE_
DENIED_ J DATE_
CONO I T IONS: y1
Applicatlon Approved For
Six Month Period Only
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